Accuracy of diagnostic tests for clinically suspected upper extremity deep vein thrombosis: a systematic review - PubMed (original) (raw)
Review
Accuracy of diagnostic tests for clinically suspected upper extremity deep vein thrombosis: a systematic review
M Di Nisio et al. J Thromb Haemost. 2010 Apr.
Free article
Abstract
Background: The best available test for the diagnosis of upper extremity deep venous thrombosis (UEDVT) is contrast venography. The aim of this systematic review was to assess whether the diagnostic accuracy of other tests for clinically suspected UEDVT is high enough to justify their use in clinical practise and to evaluate if any test can replace venography.
Methods: MEDLINE and EMBASE databases were searched from inception to June 2009. Two reviewers independently evaluated study eligibility, extracted data, and assessed study quality.
Results: We identified 17 papers, reporting on 793 patients. Overall, the methodological quality was poor, sample sizes were small, and large between-study differences were observed in spectrum and design. The summary estimates of sensitivity (95% confidence interval) were 97% (90-100%) for compression ultrasonography, 84% (72-97%) for Doppler ultrasonography, 91% (85-97%) for Doppler ultrasonography with compression, and 85% (72-99%) for phleboreography. The corresponding summary estimates of specificity were, respectively, 96% (87-100%), 94% (86-100%), 93% (80-100%), and 87% (71-100%). Clinical findings, a clinical score, D-dimer, magnetic resonance imaging, rheography and plethysmography were evaluated in one study each, involving a median number of 46 patients (range 21-214). Sensitivity and specificity ranged from 0% to 100% and from 14% to 100%.
Conclusions: Methodological limitations, large between-study differences and small sample sizes limit the evidence of tests for clinically suspected UEDVT. Compression ultrasonography may be an acceptable alternative to venography. The addition of (color) Doppler does not seem to improve the accuracy. Adequately designed studies are warranted to confirm these findings.
Similar articles
- Measurement of the clinical and cost-effectiveness of non-invasive diagnostic testing strategies for deep vein thrombosis.
Goodacre S, Sampson F, Stevenson M, Wailoo A, Sutton A, Thomas S, Locker T, Ryan A. Goodacre S, et al. Health Technol Assess. 2006 May;10(15):1-168, iii-iv. doi: 10.3310/hta10150. Health Technol Assess. 2006. PMID: 16707072 Review. - Detection of upper extremity deep vein thrombosis by magnetic resonance non-contrast thrombus imaging.
van Dam LF, Dronkers CEA, Gautam G, Eckerbom Å, Ghanima W, Gleditsch J, van Haren GR, von Heijne A, Huisman MV, Stöger JL, Westerlund E, Kroft LJM, Klok FA. van Dam LF, et al. J Thromb Haemost. 2021 Aug;19(8):1973-1980. doi: 10.1111/jth.15394. Epub 2021 Jun 16. J Thromb Haemost. 2021. PMID: 34018662 Free PMC article. - Upper-extremity deep vein thrombosis. Risk factors, diagnosis, and complications.
Prandoni P, Polistena P, Bernardi E, Cogo A, Casara D, Verlato F, Angelini F, Simioni P, Signorini GP, Benedetti L, Girolami A. Prandoni P, et al. Arch Intern Med. 1997 Jan 13;157(1):57-62. Arch Intern Med. 1997. PMID: 8996041 - Safety and feasibility of a diagnostic algorithm combining clinical probability, d-dimer testing, and ultrasonography for suspected upper extremity deep venous thrombosis: a prospective management study.
Kleinjan A, Di Nisio M, Beyer-Westendorf J, Camporese G, Cosmi B, Ghirarduzzi A, Kamphuisen PW, Otten HM, Porreca E, Aggarwal A, Brodmann M, Guglielmi MD, Iotti M, Kaasjager K, Kamvissi V, Lerede T, Marschang P, Meijer K, Palareti G, Rickles FR, Righini M, Rutjes AW, Tonello C, Verhamme P, Werth S, van Wissen S, Büller HR. Kleinjan A, et al. Ann Intern Med. 2014 Apr 1;160(7):451-7. doi: 10.7326/M13-2056. Ann Intern Med. 2014. PMID: 24687068 Clinical Trial. - Looking for deep vein thrombosis in suspected pulmonary embolism.
Emmerich J. Emmerich J. Semin Vasc Med. 2001 Nov;1(2):181-8. doi: 10.1055/s-2001-18486. Semin Vasc Med. 2001. PMID: 15199501 Review.
Cited by
- Paget-Schroetter Syndrome in a Young Female.
Sangani V, Pokal M, Balla M, Gayam V, Konala VM. Sangani V, et al. J Investig Med High Impact Case Rep. 2021 Jan-Dec;9:23247096211003263. doi: 10.1177/23247096211003263. J Investig Med High Impact Case Rep. 2021. PMID: 33749370 Free PMC article. - Prevention and treatment of catheter-related venous thrombosis in long-term parenteral nutrition: A SINuC position statement.
Zaccone V, Santoro L, Guerrieri E, Diblasi I, Roncarati I, Viticchi G, Vecchiarelli P, Santoliquido A, Fiore F, Molfino A, Landi F, Moroncini G, Gasbarrini A, Muscaritoli M, Falsetti L. Zaccone V, et al. Front Nutr. 2023 Feb 6;10:1106327. doi: 10.3389/fnut.2023.1106327. eCollection 2023. Front Nutr. 2023. PMID: 36814508 Free PMC article. Review. - Thromboembolic Presentations among Patients Hospitalized to the Intensive Care Unit for Coronavirus Disease 2019 (COVID-19) - A Northern Taiwan Single Center Experience.
Chen YC, Chen CY, Wang AY, Hou SK, Lai KSL, Chou CL, Lin YY, Lin YC, Huang CY. Chen YC, et al. Acta Cardiol Sin. 2023 Sep;39(5):695-708. doi: 10.6515/ACS.202309_39(5).20230203A. Acta Cardiol Sin. 2023. PMID: 37720401 Free PMC article. - Emergency department diagnosis of upper extremity deep venous thrombosis using bedside ultrasonography.
Rosen T, Chang B, Kaufman M, Soderman M, Riley DC. Rosen T, et al. Crit Ultrasound J. 2012 Apr 16;4(1):4. doi: 10.1186/2036-7902-4-4. Crit Ultrasound J. 2012. PMID: 22871175 Free PMC article. - Clinical challenges in patients with cancer-associated thrombosis: Canadian expert consensus recommendations.
Carrier M, Lazo-Langner A, Shivakumar S, Tagalakis V, Gross PL, Blais N, Butts CA, Crowther M. Carrier M, et al. Curr Oncol. 2015 Feb;22(1):49-59. doi: 10.3747/co.22.2392. Curr Oncol. 2015. PMID: 25684988 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical